| Entity Name: | NEW LIFE MENTAL MANAGEMENT CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 05 Sep 2017 (7 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | P17000073734 |
| FEI/EIN Number | 82-2796710 |
| Mail Address: | PO BOX 520613, MIAMI, FL, 33152, US |
| Address: | 3904 NW 164 st, Miami, FL, 33054, US |
| ZIP code: | 33054 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063921401 | 2017-09-28 | 2022-07-21 | 3904 NW 167TH ST, OPA LOCKA, FL, 330546233, US | 3904 NW 167TH ST, OPA LOCKA, FL, 330546233, US | |||||||||||||||||||||||
|
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| Phone | +1 305-393-5303 |
| Fax | 3055139338 |
Authorized person
| Name | MR. IHOSVANY ESCOBAR |
| Role | VICE PRESIDENT |
| Phone | 7864571263 |
Taxonomy
| Taxonomy Code | 251B00000X - Case Management Agency |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 685797 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ESCOBAR IHOSVANY | Agent | 72 SW 132ND COURT, MIAMI, FL, 33184 |
| Name | Role | Address |
|---|---|---|
| ESCOBAR IHOSVANY | Vice President | 5055 NW 74 AVE STE 4, MIAMI, FL, 33166 |
| Name | Role | Address |
|---|---|---|
| MORALES CARLOS | President | 5055 NW 74 AVE, MIAMI, FL, 33166 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-02-12 | 3904 NW 164 st, Miami, FL 33054 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-02-12 |
| Domestic Profit | 2017-09-05 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
